Sleep after surgery: stellate ganglion block shows a benefit that remains uncertain

Ten trials in a surgical setting

The researchers pooled ten randomized trials, conducted mainly in China, following a search of eight Chinese and international databases through January 1, 2025. Control groups received a placebo, usual care or an active intervention. These different comparators therefore do not represent a single clinical situation.

Stellate ganglion block modulates sympathetic nervous system activity. The authors propose autonomic, pain-relieving and anti-inflammatory mechanisms to explain a possible effect on sleep. These are biological hypotheses, not proof of the mechanism responsible for the results.

A favorable signal whose magnitude remains difficult to interpret

Subjective sleep scores were more favorable with the block on the night of surgery, on the first and third postoperative days, and at four weeks. However, the reported heterogeneity for subjective sleep quality was high, with an I² of 90%. The average effect therefore masks widely varying results across trials.

The review also reports approximately 72 additional minutes of sleep compared with the comparators, with a 95% confidence interval ranging from approximately 52 to 92 minutes. The abstract does not specify the measurement window for this estimate. It should not be interpreted as a guaranteed gain every night or as a promise for any individual.

The estimate of sleep efficiency was based on only two studies, which were also highly heterogeneous. The benefit observed at four weeks remained statistically significant. However, the numerical differences between time points do not demonstrate that the effect decreases over time: no formal test of this trend was performed.

What this study cannot establish

These results concern sleep after surgery. They do not establish effectiveness against chronic insomnia or a benefit for a healthy person seeking to optimize their sleep.

The dossier contains only the PubMed abstract, not the full text. Adverse effects, the precise details of the intervention, funding and conflicts of interest could not be verified. The potential benefit alone is therefore insufficient to establish a favorable benefit–risk balance.

What we can take away

Stellate ganglion block is a potential avenue for postoperative sleep, not an established treatment based on this dossier. Larger multicenter randomized trials are needed to clarify its value.